Clinical features and endovascular treatment of anterior temporal artery aneurysms

Abstract

Objective To investigate the clinical features, mechanism and endovascular treatment of anterior temporal artery aneurysm of the posterior cerebral artery. Methods The clinical data of 6 patients with anterior temporal artery aneurysm treated with endovascular treatment at the Cerebral Vascular Interventional Treatment Center, Henan Provincial People's Hospital, Zhengzhou University from January 2010 to December 2014 were analyzed retrospectively. All 6 patients were accompanied by ipsilateral middle cerebral artery or internal carotid artery occlusion. The diameter of aneurysm was 2.5 to 5.0 mm, 2 of them had subarachnoid hemorrhage, 1 did not have any symptom, and 3 were accompanied by anterior circulation cerebral ischemic symptom.Six patients were treated by endovascular management, 4 cases of unruptured aneurysms were treated by coil embolization and retain its parent artery; 2 case of subarachnoid hemorrhage aneurysm and it's parent artery were embolized by coil or Glubran 2. Aneurysm embolization density, parent artery blood flow and posterior cerebral artery blood flow were observed by postoperative DSA imaging.Patients were followed up for 3 months to 1 year. Results The immediate angiography after procedure showed that 4 patients with unruptured aneurysm were embolized densely. The parent arteries of 2 cases were patent, 1 had blood flow retardation, and 1 thrombosis caused parent artery occlusion. No new infarction foci were found after procedure. Four patients were followed up by telephone, and they did not have relevant clinical symptoms. Three patients were followed up with imaging. Their aneurysms were embolized densely without recurrence. The parent artery was patent in 1 case. The blood flow of parent artery was slightly slow in 1 case and 1 had arterial occlusion at 3 months. One patient with subarachnoid hemorrhage died of pulmonary complications after procedure, and the remaining 5 patients recovered well during the follow-up. Conclusions Anterior temporal artery aneurysm is a special type of posterior cerebral artery aneurysm. The causes of aneurysm are significantly correlated with hemodynamics. It is easy to confuse it with posterior cerebral artery trunk aneurysm and superior cerebellar artery aneurysm. Endovascular treatment is its safe and effective therapeutic approach. Key words: Intracranial aneurysm; Anterior temporal artery; Endovascular treatment